eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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4/2022
vol. 18
 
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abstract:
Original paper

Diffusion-tensor magnetic resonance imaging of the human heart in health and in acute myocardial infarction using diffusion-weighted echo-planar imaging technique with spin-echo signals

Weronika Mazur
1
,
Małgorzata Urbańczyk-Zawadzka
2
,
Łukasz Czyż
3
,
Ewa Kwiecień
3
,
Robert Banyś
2
,
Piotr Musiałek
3
,
Artur T. Krzyżak
4

1.
Faculty of Physics and Applied Computer Science, AGH University of Science and Technology, Krakow, Poland
2.
Department of Radiology, John Paul II Hospital, Krakow, Poland
3.
Department of Cardiac and Vascular Diseases, Jagiellonian University, John Paul II Hospital, Krakow, Poland
4.
Faculty of Geology, Geophysics and Environmental Protection, AGH University of Science and Technology, Krakow, Poland
Adv Interv Cardiol 2022; 18, 4 (70): 416–422
Online publish date: 2022/11/19
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Introduction:
Originally thought unsuitable due to proneness to myocardial motion and susceptibility artefacts, spin-echo echo planar imaging (SE-EPI) has gained attention for the cardiac diffusion-weighted imaging (DWI) and diffusion tensor imaging (DTI) offering higher SNR and lower achievable echo time (TE). Aim: The application of DTI for patients with acute myocardial infarction (AMI) using our methodology developed on the basis of the SE-EPI sequence.

Material and methods:
Twelve patients with AMI and six healthy controls were enrolled in the preliminary DTI study within the CIRCULATE STRATEGMED 2 project. Our method relied on a pilot ECG-triggered DTI examination, based on which the initial evaluation was possible and allowed proper manipulation of TE (64/47 ms for patients/control), repetition time (TR) and ECG trigger delay in the consecutive DTI.

Results:
The study demonstrated that by using our algorithm it was possible to obtain DWI images showing infarct zones identified on T1-weighted images with late gadolinium-enhancement (LGE) with division into subtle and severe damage. Quantitative DTI showed increased mean diffusivity (MD) and decreased fractional anisotropy (FA) in the infarct compared to remote tissue. The application of B-matrix spatial distribution (BSD) calibration allowed the improvement of FA.

Conclusions:
Our algorithm is suitable for qualitative assessment of infarction zones with different severity. The analysis of the quantitative DTI showed that despite the lack of motion compensation blocks in the applied SE-EPI sequence, it was possible to approach the diffusion tensor parameter values reported for the myocardium.

keywords:

acute myocardial infarction, cardiac diffusion-weighted imaging, cardiac diffusion tensor imaging, spin-echo echo-planar imaging

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